Use of Real-Time Ultrasonography to Diagnose Pseudolabor

Abstract

Pseudolabor has been reported in a handful of cases over the past 20 years and has been proposed as a subtype of conversion disorder. Pseudolabor is not well understood and remains a challenge for obstetrical providers to diagnose early enough so as to prevent unnecessary use of tocolytics and other unnecessary care for preterm labor. Contraction patterns observed in pseudolabor patients have classically been described with 2 different morphologies, both caused by prolonged abdominal skeletal muscle contraction. One morphology is described as “spiked,” abrupt in onset, and abrupt in descent. The second is described as an abrupt onset, plateau or flattop phase, followed by an abrupt descent. Here we describe a case of a 30-yearold woman who presented with signs suspicious for pseudolabor whose contraction patterns were convincing for uterine smooth muscle contractions. In this case, real-time ultrasound was used to demonstrate that the uterus was not contracting, thus confirming a diagnosis of pseudolabor.